AbstractIntroductionHealthy dietary practice is important in preventing diabetes, managing existing diabetes, and preventing, or at least slowing the rate of diabetes complication development. It is, therefore, important at all levels of diabetes prevention. The objective of this study was to determine the association of dietary practice with glycaemic control among Type 2 diabetes mellitus (T2DM) patients, who received treatment from an urban Health Clinic in Kuala Lumpur.MethodsA total of 307 patients with T2DM aged 18 years and above participated in this study. A pre-tested structured questionnaire with guided interview was used to collect information on socio-demographic, clinical and dietary practice. Anthropometric and biological measurements were also taken. Descriptive statistics and Chi-square were used in the data analysis. Good glycaemic control was defined as HbA1c level less than 6.5%.ResultsThe prevalence of good glycaemic control was only 27% (n=83). The highest percentage of good glycaemic control were among male patients (29.1%), aged 60 and above (33.3%), educational level of primary school (35.4%) and those with monthly income group between RM1001 to RM1500 (32.0%). About three quarter of T2DM patient (n=224) had poor control of HbA1c (≥6.5%). Age (p=0.045) and working status (p=0.039) had significant relationship with the level of HbA1c. Dietary practice showed no significant relationship with the HbA1c level.ConclusionsEffective interventional health education strategies are needed, focussing on modification of dietary behaviour in order to achieve glycaemic control among diabetic patients.
World Health Organization. Prevention of diabetes mellitus. Technical Report Series no. 844. Geneva: World Health Organization, 1994.
Institute for Public Health (IPH) 2008. The Third National Health and Morbidity Survey (NHMS III) 2006, vol. 2. Ministry of Health, Malaysia.
Institute for Public Health (IPH) 2011. National Health and Morbidity Survey 2011 (NHMS 2011), vol. ll: Non-Communicable Disease; 2011: 188 pages.
Institute for Public Health (IPH) 1996. The Second National Health and Morbidity Survey (NHMS II) 1996. Ministry of Health, Malaysia.
Eid M, Mafauzy M, Faridah AR. Glycaemic control of type 2 diabetic patients on follow up at Hospital Universiti Sains Malaysia. Malays J Med Sci. 2003; 10(2): 40-49.
Ismail IS, Wan Nazaimoon WM, Wan Mohamad WB, Letchuman R, Singaraveloo M, Pendek R, Faridah I, Rasat R, Shariff IH. & Khalid BAK. Socio-demographic determinants of glycaemic control in young diabetic patients in peninsular Malaysia. Diabetes Res Clin Pr. 2000; 47: 57-69.
Pastor JG, Warshaw H, Daly A, Franz M, Kulkatni K. The evidence for the effectiveness of medical nutrition therapy in diabetes management. Diabetes Care. 2002; 25 (3): 608-613.
Pi-Sunyer FX., Maggio CA, McCarron DA, Reusser ME, Stern JS, Haynes RB, Oparil S, Kris-Etherton P, Resnick LM, Chait A. et al. Multicenter randomized trial of a comprehensive prepared meal program in type 2 diabetes. Diabetes Care. 1999; 22 (2): 191-197.
Kulkarni K, Castle G, Gregory R, Holmes A, Leontos C, Powers M, Snetselaar I, Splett P, Wylie-Rosett J. Nutrition Practice Guidelines for Type 1 Diabetes Mellitus positively affect dietitian practices and patient outcomes. The Diabetes care and education Dietetic Practice Group. J Am Diet Assoc. 1998; 98(1): 62-70.
Clinical Practice Guidelines. Management of Type 2 Diabetes Mellitus (4th edition). MOH/P/PAK/188.09 (GU). 2009.
Haliza AM, Roslan Johari MG, Badrulnizam M, Rosidah SS, Teng SC, Saiful Safuan MS, Tahir A, Musliha D, Haznee N, Nadirah R. Management of Patients with Type II Diabetes Mellitus in MOH Hospitals and Health Centres. J Health Manag. 4(1): 73 - 87.
Tan SL, Juliana S, Sakinah H. Dietary Compliance and its Association with Glycaemic Control among Poorly Controlled Type 2 Diabetic Outpatients in Hospital Universiti Sains Malaysia. Mal J Nutr. 2011; 17(3): 287-299.
Hernandez-Ronquillo L, Tellez-Zenteno JF, Garduno-Espinosa J, Gonzalez-Acevez E. Factors associated with therapy noncompliance in type-2 diabetes patients. Salud Publica Mex. 2003; 45(3): 191–197.
Howteerakul N, Suwannapong N, Rittichu C, Rawdaree P. Adherence to regimens and glycaemic control of patients with type 2 diabetes attending a tertiary hospital clinic. Asia Pac J Public Health. 2007; 19 (1): 43–49.
Kirkman MS, Jones Briscoe V, Clark N, Florez H, Haas LB, Halter JB, Huang ES, Korytkowski MT, Munshi MN, Odegard PS, Pratley RE, Swift CS. Diabetes in Older Adults: A Consensus Report. J Am Geriatr Soc. 2012; 60(12): 2342 – 2356. doi: 10.1111/jgs.12035.
Meisinger C, Thorand B, Schneider A. Sex differences in risk factors for incident type 2 Diabetes mellitus: the MONICA Augsburg cohort study. Arch Intern Med. 2002; 162: 82-89.
Tuomilehto J, Lindstrom J, Eriksson JG etc. Prevention of type 2 Diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. New Engl J Med. 2001; 344:1343-1350.
Nur Shazwani MN, Suzana S, Hanus Mastura Y, Lim CJ, The SC, Mohd Fauzee MZ, Lim HC, Dahlia S, Norliza M. Assessment of physical activity level among individuals with type 2 diabetes mellitus at Cheras Health Clinic, Kuala Lumpur. Mal J Nutr. 2001; 16(1):101-112.
Center for Disease Control and Prevention. Prevalence of Health Care Providers asking older adults about their physical activity levels – United States. 1998. Morb Mort Wkly Rep. 2002; 51(19):412-420.
Lawton J, Ahmad N, Hanna L, Douglas M, Hallowell N. ‘I can’t do any serious exercise’: barriers to physical activity amongst people of Pakistani and Indian origin type 2 diabetes. Health Edu Res. 2005; 21(1):43-54.
Suhaiza S, Ahmad Nasir M, Jeriah I, Abdul Aziz Al Safi I, Wan Mohammad WB & Mafauzy M. Glycaemic control among type 2 diabetic patients in Kelantan. NCD Malaysia. 2004; 3: 19-22.
Haney W, Yue-Fang C. Factor associated with glyceamic control patients with type 2 Diabetes mellitus in rural areas of the United States. Insulin. 2007; 2:134-141.
Rothenbacher D, Rüter G, Saam S & Brenner H. Younger patients with type 2 diabetes need better glycaemic control: results of a community-based study describing factors associated with a high HbA1c value. Br J Gen Pract. 2003; 53: 389-391.
Hartz A., Kent S, James P, Yinghui X, Kelly M & Daly. Factor that influence improvement for patients with poorly controlled type 2 diabetes. Diabetes Res Clin Pract. 2006; 74: 227-232.
Khattab MS, Aboifotouh MA, Khan MY, Humaidi MA, Al-Kaldi YM. Compliance and control of diabetes in a family practice setting, Saudi Arabia. East Mediterr Health J. 1999; 755-765.
Tooze J, Sabar A, Thompson F, Troiano R, Schatzkin A, Kipnis V. Psychosocial predictors of energy underreporting in a large doubly labelled water study. Am J Clin Nutr. 2004; 79 (5): 795–804.
Pereire MA, Kartashov AI, Ebbeling CB, Van Horn L, Slattery ML, Jacob DR Jr, Ludwig DS. Fast-food habits, weight gain and insulin resistance (the CARDIA study): 15-year prospective analysis. Lancet. 2005; 365 (9453):36-42.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.